GKD Anest Yoð Bak Dern Derg. 2018; 24(2): 45-59 | DOI: 10.5222/GKDAD.2018.20092

Sevofluran ve izofluran’ýn saðlýklý rat akciðeri üzerine inflamatuar etkilerinin incelenmesi

Fatma Acýl, Cem Kývýlcým Kaçar, Osman Uzundere, Sedat Kaya, Abdulkadir Yektaþ
TC. SBÜ Diyarbakýr Gazi Yaþargil Eðitim ve Araþtýrma Hastanesi

GÝRÝÞ ve AMAÇ: Çalýþmamýzda izofluran ve sevofluranýn saðlýklý rat akciðerindeki inflamatuar etkilerini incelenmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Yirmibir adet rat rastgele üç gruba ayrýldý. Kontrol Grubu (n=6); %50 oksijen + %50 hava; Ýzofluran Grubu (n=7) % 1.2 Ýzofluran + %50 oksijen + %50 hava, Sevofluran Grubu (n=6) % 2.5 Sevofluran + %50 oksijen + %50 hava ile 2 saat mekanik ventilatör ile solutuldu. Gruplarýn MPO aktiviteleri, TBARS düzeyleri, alveoler makrofaj sayýlarý ve alveoler epiteliyal apoptotik hücre sayýlarý istatistiksel olarak deðerlendirildi. p<0.05 deðeri istatistiksel olarak anlamlý kabul edildi.
BULGULAR: Sevofluran Grubu’nda, Kontrol ve Ýzofluran Grubu’na göre MPO aktivitesi ve TBARS düzeyi anlamlý derecede düþük saptandý. Ýzofluran Grubu’nda, Kontrol ve Sevofluran Grubu’na göre alveoler makrofaj sayýsý ve M-30 pozitif hücre sayýsý anlamlý yüksek, Sevofluran Grubu’nda ise Kontrol Grubu’na göre anlamlý yüksek olarak saptandý. Iþýk mikroskobik incelemede Sevofluran grubu ve daha fazla olmak üzere Ýzofluran Grubu’nda yaygýn mononükleer hücre infiltrasyonu, diffüz alveoler hasar, alveoler ödem, alveoler septumlarda kalýnlaþma, alveol lümeninde yoðun alveoler makrofaj ve daha az miktarda nötrofil ve tip II pnömositler gözlendi.
TARTIÞMA ve SONUÇ: Bu çalýþmanýn sonuçlarý bize, sevofluranýn saðlýklý rat akciðeri üzerine inflamatuar etkisinin izoflurana göre daha az olduðunu düþündürdü.

Anahtar Kelimeler: izofluran, sevofluran, akciðer hasarý, apoptozis, genel anestezi

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Analysis of the imflammatory effects of sevoflurane and izofluran on healty rat lung

Fatma Acýl, Cem Kývýlcým Kaçar, Osman Uzundere, Sedat Kaya, Abdulkadir Yektaþ
TR. MSU Diyarbakýr Gazi Yaþargil Training and research hospital

INTRODUCTION: We aimed to investigate the effects of isoflurane and sevoflurane on lung inflammation and alveolar epithelial apoptosis in rat model.
METHODS: Twenty-one rats were randomly allocated into three groups. The subjects were mechanically ventilated for 2 hours in Control group (n=7) with 50 % oxygen + 50 % air mixture; in Isoflurane group (n=7) with % 1.2 isoflurane + 50 % oxygen + 50 % air and in Sevoflurane Group (n=7) with %2.4 sevoflurane + 50 % oxygen + 50 % air mixture. The MPO activities of the groups, TBARS levels, alveolar macrophage counts and alveolar epithelial apoptotic cell counts were.evaluated statistically.
RESULTS: MPO activity in Sevoflurane group compared to isoflurane and control groups were significantly low. Furthermore, TBARS levels in Sevoflurane group compared to the other groups were also significantly low. MPO activity in Isoflurane group were significantly high compared to control group. Alveolar macrophage counts and M-30 positive cell counts in Isoflurane group were significantly high compared to sevoflurane and control groups. On the other hand, the alveolar macrophage counts and M-30 positive cell counts in sevoflurane group were significantly high compared to control group. Light microscopic findings observed in sevoflurane group and any more in isoflurane group were; diffuse mononuclear cell infiltration, diffuse alveolar injury, alveolary oedema, thickening of alveolar septums, dense alveolar macrophage and light neutrophil and type II pneumocytes infiltration in alveol lumen.
DISCUSSION AND CONCLUSION: According to the results of this study, sevoflurane was found to cause less alveolar injury in healthy lung than isoflurane.

Keywords: Isoflurane, sevoflurane, lung injury, apoptosis, general anesthesia

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